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July 1949

COMBINED LATERAL AND VENTRAL PYRAMIDOTOMY IN TREATMENT OF PARALYSIS AGITANS

Arch NeurPsych. 1949;62(1):27-47. doi:10.1001/archneurpsyc.1949.02310130033002
Abstract

IN RECENT years there has been great interest in the surgical treatment of parkinsonism, following the work of Bucy and Case,1 in 1939, which demonstrated that it was possible to relieve tremor by operative means. Previously it had been shown that the medical treatment of paralysis agitans was unsatisfactory. There had been long experience with various drugs, primarily those of the atropine series, which provided only transient and slight relief. The inadequacy of medical measures necessitated a more radical approach, which in the past ten years has produced a variety of surgical technics.

Meyers2 set up criteria for an ideal operative procedure for the relief of tremor, of which the following are important:

  1. The benefits to be anticipated from the operation should be commensurate with the risks involved.

  2. No impairment of function beyond that already in evidence should result from the operative procedure. Ideally, the operation should not

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